Wednesday, 10 January 2018

Cancer warnings on alcohol are unjustified

As reported in the Guardian,
the Alcohol Health Alliance is concerned that only ten per cent of
Britons are aware of the link between drinking and cancer. They are
demanding cigarette-style warnings on alcoholic beverages to remedy
this. There are several reasons why this would not be a good idea.

The evidence that only one in ten people is aware of the alcohol-cancer link comes from a survey conducted in September 2017
which asked respondents to spontaneously name diseases that they
associate with alcohol consumption. It might have been better to ask a
question along the lines of ‘do you believe that drinking increases the
risk of some cancers (yes/no)?’ If cancer risk was not front of mind
when the respondents answered the survey, we should not be surprised.
The cancers associated with drinking are mostly quite rare. The lifetime
risk of dying from these diseases is mercifully small and, for people
who drink moderately and do not smoke, the increased risk from alcohol
consumption is trivial to non-existent.

The exception is breast cancer, which appears to be linked to
drinking even at low levels – hence the Chief Medical Officer’s claim
that there is no safe level of drinking – but the evidence for this has only appeared in recent years and there are reasons to be sceptical of it.
Even if the statistical associations between moderate drinking and
breast cancer are real and causal, the magnitude of risk is so small
that it is unlikely to persuade many women to go teetotal.

Nevertheless, don’t people have the right to know about these risks?
Don’t we free market liberals want informed consumers? Well, yes we do.
The question is how we go about telling them. Britain is not California.
We do not plaster cancer warnings on every product on the shelves. We do not demand health warnings on bacon, steak, french fries and ‘very hot drinks’,
even though they have all been declared carcinogenic (or ‘probably
carcinogenic’) by the International Agency for Research on Cancer.

Plenty of everyday products have been linked to cancer or can cause
harm if abused. With the exception of cigarettes, we do not demand
health warnings on them because the risks are not particularly great and
there are plenty of other ways for people to get this information if
they are interested. Indeed, there are ways for people to be given this
information even if they are not interested. Public Health England spent a staggering £4.5 billion last year.
The British taxpayer pays for an army of ‘public health professionals’.
If they wanted to inform people about the cancer risks associated with
drinking, they have the resources with which do so.

I am not against labelling per se. People have a right to
know what they are buying and I am in favour of putting calorie counts
on alcoholic drinks. But a functioning market does not require consumers
to know every possible cost and benefit before they make a purchase,
and it certainly doesn’t require every possible cost and benefit to be
listed on the label.

Let’s be realistic about this. The Alcohol Health Alliance are not
demanding cancer warnings on wine bottles because they want consumers to
be fully informed. They want cigarette-style health warnings because
they want to treat alcohol like cigarettes. They want every bottle and
can to scream a message that ‘Alcohol causes cancer’ and ‘Drinking
kills’ in order to deter people from buying the product. Moreover, they
want these messages to be carried alongside graphic photographs of diseased livers.

This would not lead to the public being better informed. On the
contrary, it would mislead people into thinking that the cancer risks
associated with drinking were of the same magnitude as those associated
with cigarettes.

What would an accurate health warning on alcohol look like? I tackled this question in my book, Killjoys:

The British public, we are told, are woefully
ignorant about the link between alcohol and cancer, and labelling drinks
with a cigarette-style cancer warning would be an effective way to
spread the word. Perhaps it would, but the risks are so small in
practice that such a system would either discredit scientific advice in
the eyes of the public or alarm consumers to such an extent that they
would make worse choices than if they remained ignorant. A truthful
alcohol label would explain that associations have been found between
alcohol consumption and several cancers, most of which are rare. It
would explain risks in absolute, rather than relative, terms (e.g.
‘Heavy drinking increase your lifetime risk of developing disease X from
Y per cent to Z per cent’). Finally, it would explain that moderate
consumption of alcohol reduces the risk of heart disease, stroke and
diabetes, and that premature death is less common among moderate
drinkers than teetotallers, although heavy drinkers have a higher
mortality rate than either.

Aside from the fact that this is too wordy to fit onto a bottle
of wine, a label that explained the science adequately would make
consumers better informed whereas a warning saying ‘alcohol causes
cancer’ would lie by omission. A truthful label would probably have no
effect on alcohol consumption other than possibly increasing it. It is
questionable whether it is worth putting it on the bottle at all,
particularly since the information is available from other sources for
those who are interested. And yet it is only the verbose yet truthful
label, not the crude cancer warning favoured by paternalists, that can
be ethically justified if the aim is to inform rather than alarm.

The ‘public health’ lobby is not interested in educating people about
the health effects of alcohol consumption. One only needs to look at
its campaign of doubt and denial over the benefits of moderate drinking
to see that. There is no more justification for putting health warnings
on alcoholic drinks than there is for putting them on sausages.

About Me

Writer and researcher at the Institute of Economic Affairs. Blogging in a personal capacity.
Author of Selfishness, Greed and Capitalism (2015), The Art of Suppression (2011), The Spirit Level Delusion (2010) and Velvet Glove, Iron Fist (2009).

"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."